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Scars & Burns by Mr Ioannis Goutos

Tissue Expander

Tissue Expander

At a glance

Treatment time:

Tissue expanders require 2 operations with an interval of 4-6 months of expansion in between, depending on the nature of the final surgery.


The surgery to insert a tissue expander typically takes around 1 hour.

Return to work:

Dependent on the nature of work and site of the expander, the initial surgery can be done as a day case so light duties/office-based work can be resumed within a few days.


General anaesthetic or local anaesthetic with sedation.

Tissue expanders are a special surgical technique that can be used to create ‘extra’ skin tissue which can then be used to repair or reconstruct target areas of skin, such as scarring (particularly that related to burn injuries) and large birthmarks.

Tissue expander techniques are also commonly used in breast reconstruction surgery following mastectomy (removal of a breast). This method involves inserting a silicone balloon under the skin which is then gradually expanded over the next few weeks to months to create slow stretching in the skin.

This creates ‘extra’ skin tissue. Once there is enough extra skin present, the expander is removed and the additional skin can be used to replace or repair the area of scarring or birthmark. Tissue expanders carry special advantages as they allow the surgeon to use the patient’s own skin, with an established blood supply and nerves, which can help to reduce complications such as tissue rejection or tissue death.

Mr Ioannis Goutos is an expertly skilled plastic surgeon, with extensive experience in managing individuals with scars and burns. He offers a wide range of surgical and non-surgical treatments, including body contouring procedures. Mr Goutos takes great care to ensure that all aspects of each person’s care are addressed to create a bespoke treatment plan and aftercare for them.

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About this treatment

Prior to your procedure, you will undergo a thorough pre-operative assessment, which may include a physical examination, review of any medications that you take and some basic medical investigations. Tissue expander surgery can be done under either a general anaesthetic (when you will be unconscious throughout the operation) or with local anaesthetic and sedation (whereby you will not be able to feel the operation and will feel sleepy and less aware of what is going on around you). Once safely under anaesthetic or sedation, the surgeon will make a small incision in the skin and place the expander balloon underneath. The incision is then closed using appropriate sutures. Once the wound has healed sufficiently (typically around 2 weeks), the balloon is slowly inflated with a sterile saline solution using a port under the skin. Usually the balloon is expanded once a week until the target volume is reached and there is sufficient skin for the repair surgery. A second operation is then carried out, again under either a general anaesthetic or sedation, and the expander device is removed. The additional stretched skin can then be used to repair the area of scarring as needed. In breast reconstruction, the expander is placed in the location of the new breast, and once the skin is expanded, implants can be inserted underneath.

If you are interested in tissue expander surgery and want to find out more, it is important to have a full discussion and assessment with an experienced plastic surgeon to ensure that you are getting the right treatment for you and your treatment goals.

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Goutos London - Tissue expander
Goutos London - FAQ


We know having medical, surgical or cosmetic treatment can seem daunting and it is natural to have questions. We are here to ensure your comfort and safety at all times. If you are unable to find the answer to your questions below, then please do not hesitate to contact us so we can help.

There are some general risks that are associated with any surgical procedure, including risks of infection, bleeding and blood clots. These risks are reduced with thorough pre-operative planning, medication reviews and good post-operative care. With tissue expanders, there is a small risk of the tissue expander leaking after it has been implanted under the skin. If any leaking, or infection, occurs around the tissue expander, the expander balloon is removed and replaced with a new device in an additional operation.

Prior to tissue expander devices, surgeons typically used skin flaps or skin grafts for skin repair and reconstruction. This options are still available and may be more suitable for certain individuals depending on their treatment goals and area of skin being targeted.

For small areas of repair, sufficient additional skin can be created within 3-4 monthss of tissue expansion. However, this is highly dependent on the total area and location of skin that is being treated. Larger and more extensive repairs may warrant tissue expansion over a period of several months. These factors can be discussed in advance of your surgery and during the pre-operative planning.

Any surgical procedure will inevitably leave some scarring. If you are worried about the appearance and quality of the end scarring, this should be discussed with your surgeon in advance of any operations. Additional techniques such as tension-relieving suturing methods and adjuncts in aftercare can help to improve the appearance of the final scarring. If you are particularly prone to problem scarring, such as hypertrophic or keloid scars, this should also be discussed with your surgeon during the pre-operative assessment and planning stages.

Prices from

Starting from £3000

At Goutos London, we aim to deliver a premium service with no compromise on quality in order to deliver the best results possible for your needs.

Goutos London

Related conditions

Whatever your condition, and whatever your health goals are, we will ensure you get a holistic, focused and bespoke service that offers you the safest options for treatment aiming for the best possible outcome.



Tight scars


Mr Goutos is delighted to share some of his patient and peer feedback on their experiences of his services.

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